CCRN Plan

Musculoskeletal, Neurological, Behavioral/Psychosocial: practice questions

3 original questions · 3 editor-approved · every choice explained.

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Blueprint-mapped questions with full rationales for every choice.

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Musculoskeletal, Neurological, Behavioral/PsychosocialDifficulty 3/5

A patient with a traumatic brain injury has an intracranial pressure of 25 mmHg and a mean arterial pressure of 70 mmHg. What is the cerebral perfusion pressure, and why does it matter?

  1. A70 mmHg, which reflects systemic pressure and is sufficient
  2. B95 mmHg, which is adequate and requires no further intervention
  3. C45 mmHg, which is below target and threatens cerebral ischaemia
  4. D25 mmHg, which reflects the intracranial pressure alone
Show answer and rationale

Correct: C. CPP = MAP − ICP = 70 − 25 = 45 mmHg, below the usual target range and associated with secondary ischaemic injury. Management addresses both sides of the equation: lower ICP and support MAP.

  • B — 95 would be the sum rather than the difference.
  • D — ICP alone is not perfusion pressure.
  • A — MAP alone ignores the opposing intracranial pressure.
Musculoskeletal, Neurological, Behavioral/PsychosocialDifficulty 2/5

A previously calm ventilated patient becomes acutely agitated overnight. What should be assessed first?

  1. AApply physical restraints and reassess in the morning with the day team
  2. BRequest an urgent psychiatric consultation for the behavioural change
  3. CIncrease sedation to protect the airway and prevent self-extubation
  4. DScreen for hypoxaemia, pain, bladder distension and withdrawal first
Show answer and rationale

Correct: D. Acute agitation is a symptom. Hypoxaemia, pain, urinary retention, withdrawal and metabolic causes must be screened before sedation, which would otherwise mask a treatable deterioration.

  • C — Sedating first can conceal hypoxaemia or another emergency.
  • A — Restraints do not diagnose the cause and carry their own harms.
  • B — A psychiatric cause is a diagnosis of exclusion in a ventilated ICU patient.
Musculoskeletal, Neurological, Behavioral/PsychosocialDifficulty 3/5

Which set of findings suggests impending herniation in a patient with rising intracranial pressure?

  1. ACushing’s triad with a newly dilated pupil, indicating brainstem compression
  2. BHypotension, tachycardia and rapid shallow breathing with equal pupils
  3. CNormal vital signs with a gradually improving level of consciousness
  4. DFever, tachycardia and hypotension consistent with an early septic response
Show answer and rationale

Correct: A. Cushing's triad — hypertension with a widening pulse pressure, bradycardia and irregular respirations — combined with a unilateral dilated pupil indicates brainstem compression and demands immediate intervention.

  • B — That pattern suggests hypovolaemia or shock rather than herniation.
  • C — Improving consciousness is inconsistent with herniation.
  • D — Those findings describe sepsis.

Primary references

  1. CCRN Exam Handbook — Direct Care (July 2026) — AACN Certification Corporation · primary · retrieved 2026-09-22, verified 2026-09-22